Module 5: Health Management of the Elderly I - Overview

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This module was developed by Carol Oliver, MSN, FNP-C. For additional background on Ms. Oliver, select the name.

Introduction

Geriatric patient care management can be challenging because of the clinical complexity of geriatric disorders and the variations of experiences that accompany a patient's long life. Planning geriatric patient care requires an awareness of the interactions of pathologies, treatments, life experiences, family and other support systems, as well as a new scientific discoveries and other contextual factors. Additionally, communication with the older adult and involving him or her in health care decisions are important factors in the process of care.

The overall goal of these Health Management modules is to help you understand the special needs of older adults and apply this understanding to your plan of care. It will involve recognizing how changes due to aging and other characteristics of the elderly affect the prescription of medications and their effects, the success of other kinds of treatments, the teaching of self care, and the outcomes of patient care in general.

The Health Management modules differ from other modules in the Geriatric Concepts curriculum in that they utilize a case-based approach to presenting these issues. Playing the role of an NP providing important primary care to seniors, you will be introduced to four hypothetical patients and asked to determine the best approach to assessing their health status. You will have the opportunity to review pertinent "clues" as to each patient's condition, recognize the relevant clinical issues, and sort out those issues and clinical data that are relevant to the patient's plan of care. In the process, you will learn how to be in touch with your older clients---and be as successful at resolving the case as Sherlock Homes!

Objectives

• Describe the incidence, assessment, classification, and health care implications of common pathophysiological conditions experienced by older adults.
• Given the knowledge of these conditions, and a series of specific patient complaints, determine:
  • Potential health risks for the patient
  • Priority issues you would want to address when taking the patient's health history
  • Primary questions to ask the patient in order to further explore these risks and issues
• Given the patient's age, presenting complaints, and health risks, as well as a knowledge of the normal physiological changes associated with aging, describe:
  • Expected findings from the physical exam of the patient
  • Areas to assess during the physical exam
• Based on the findings from the physical exam, revise the initial problem list for the patient
• Based on the findings from the patient's history and physical exam, and identified health risks:
  • Determine diagnostic studies should be ordered
  • Identify teaching points important to include
• Based on the findings from the patient's history, physical exam, and diagnostic studies, as well as the identified health risks for the patient:
  • Determine what follow-up examinations, diagnostic studies, or referrals may be warranted
  • Re-prioritize the problem list for the patient
• Devise a care plan for the patient that addresses the three priority health problems.